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August 1958

Infarction of the Entire Right Lobe of the Liver

Author Affiliations

Houston, Texas
From the Department of Surgery, Hermann Hospital.; Formerly Chief Resident, Department of Surgery, Hermann Hospital; currently Resident in Thoracic Surgery, Hahnemann Medical College and Hospital, Philadelphia (Dr. Fitch). Attending Surgeon, Department of Surgery, Hermann Hospital (Dr. Denman).

AMA Arch Surg. 1958;77(2):235-238. doi:10.1001/archsurg.1958.01290020085016

Infarction of the liver in the broadest sense is not particularly uncommon. Massive infarcts, however, are quite rare, and total right-lobe infarction is a distinct rarity.12

For generations there have been widespread misconceptions regarding the histologic and gross anatomy of the liver. The segmental anatomy is only recently receiving long-overdue attention in the clinical surgical literature. The monumental works of Elias2-4 and Michels7 have been instrumental in acquainting clinicians with the significant details which have for so long been incorrectly presented in our medical schools.

The newer concepts of the histologic anatomy of the liver is beyond the scope of this paper. The pertinent points regarding the gross and segmental anatomy, and their variance with the classical teachings are briefly reviewed here. These facts should help explain the highly variable responses elicited after hepatic artery ligation, portal vein thrombosis, portacaval anastomoses, and arterial interruptions secondary to extrahepatic